The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 25, 2010 #3,893 Publisher-Barry Block, DPM, JD

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We've just posted an article titled "Doctor, You've Been Sued!" by Howard Rosenbaum, DPM which appears in the June/July issue of Podiatry Management.

Dr. Howard Rosenbaum

You can access this interesting and informative article by clicking here. 

CA Podiatrist Not Convinced By Toning Shoe Studies

Toning shoes are designed to simulate the feeling of walking on sand and make wearers stabilize their steps, leading to stronger leg, buttock, back, and abdominal muscles, according to Skechers, maker of the Shape-ups toning shoe. Reebok says its EasyTones generate 28 percent more gluteus maximus muscle activation than a typical walking shoe, and 11 percent more in the hamstrings and calves. Both companies cite research and testing that they commissioned to back up the claims.

Dr. John Pagliano

John Pagliano, a podiatrist in Long Beach, CA, says he gets asked about toning shoes several times a day and he doesn't recommend them. While he said the instability in the shoes causes muscles to work harder, he hasn't seen enough evidence to believe it can firm wearers' backsides. "I say I'm not really sure, and I haven't been convinced by the studies," said Pagliano, who specializes in athletic injuries. 
 
Source: Matt Townsend, Bloomberg Business Week [6/3/10]

6th Annual Glass Slipper Fete Raises Over $41,000 for the Student Scholarship Fund

The 6th Annual Glass Slipper Fete was recently held in Independence, Ohio. The evening featured fine food and drinks, live and silent auctions, and the fantastic music of Rick and the Cutting Edge! Guests spent time perusing the silent auction, which included many exciting items, like autographed footballs and basketballs, trips to Las Vegas, a kitten and a puppy! Guests were also able to purchase jewelry, courtesy of Lucky Jewelers.  

Dr. Mildred Dixon at the Glass Slipper Fete

Source: OCPM Footsteps [June 2010]

ME to Test New Medicaid Billing Software

Maine will begin testing a new Medicaid billing system at various sites next week as the Maine Department of Health and Human Services works to replace a troubled computer network. In Augusta, Dr. Daniel Benson, a podiatrist, has had trouble with the old system. His wife, Paula Benson, who manages the billing for the office, said she's worried about the change. "I think we're all going to be on alert; that we're not going to let it go months and months," she said. "If we don't get a check within two weeks, we'll call."

Dr. Daniel Benson

She said nearly half the patients who use her husband's practice are Medicaid- or Medicare-eligible. Over the past five years, she said, it has cost her time and money to work with the state to get the Medicaid claims processed properly. "From January 2005 to now, it has cost us money. We've had to do thousands of claims by paper."

Source: Susan Cover, Kennebec Journal [6/23/10]

PA Podiatrist Says Proposed Moratorium on Gas Drilling is Too Little, Too Late

State Rep. Phyllis Mundy on Monday told a cadre of natural gas drilling opponents that she would introduce two bills and one resolution later this week to help protect public water supplies and strengthen laws governing gas drilling during a proposed moratorium on the issuing of new drilling permits.

Dr. Thomas Jiunta (photo courtesy of the Wilkes-Barre, PA Times Leader)

Dr. Tom Jiunta, a podiatrist from Lehman Township and founder of the Gas Drilling Awareness Coalition, said “legislation is too little too late” and called for a complete end to drilling, not just a moratorium on additional drilling. John Nowak Sr., of Lake Township, held up a sign asking motorists to “honk your horn to stop the gas drilling.” Quite a few drivers heeded his plea during the 45-minute event. He said about half of those gathered around him were new faces to him at events. He said it shows the message is getting out, the public is becoming better educated and residents were finding their voice.

Source: Andrew Seder, Times-Leader [6/22/10]

IG Releases Its Semi-Annual Enforcement Report

The HHS Office of Inspector General expects Medicare and Medicaid recoveries for the first half of fiscal year 2010 to reach more than $3 billion, OIG says in its Semi-annual Report to Congress, released June 14. The recoveries for October 2009 through March 2010 include about $667 million from audits and $2.5 billion from investigations, OIG says.

So far in FY 2010, which ends Sept. 30, OIG has excluded 1,935 individuals and entities, which means they can’t participate in federal healthcare programs. It also reports 293 criminal actions and 164 civil cases. To read the entire report, go to oig.hhs.gov and click on “What’s New.”

Source: Report On Medicare Compliance [6/21/10]

Back Staff Away from Feuds

Conflict is as inevitable as breathing. However, not every instance has to become a full-blown feud. Use these tactics to ensure that employees deal with disagreements in productive ways:

•  Identify the problem. Make sure that everyone agrees on what the issue is. You may discover that they are arguing about different things and may not be aware of their counterparts’ concerns.
•  Share perspectives. Let all staffers involved clarify their points of view and share their opinions about the problem.
•  Discuss each person’s vision of the ideal outcome. They might be surprised to realize that their ideals are not so far apart, even if they differ on the method for arriving at that conclusion.
•  Commit to action steps. Discuss what each person can do to meet the group goal as well as to satisfy individual concerns. Will the result be worth the time and energy that the group will have to invest? If not, what more realistic solution can you agree on?
•  Look for areas of compromise. Can everyone agree on certain parts of the issue and proposed solution? If not, take a long-term view and identify changes you can ease into place.

Source: Adapted from “Tips for Dealing With Workplace Conflict,” via Communication Briefings 

Query: Distal Toe Problem

My patient saw a podiatrist in Florida who debrided an onychomycotic hallux nail. She reports that two days later, the skin above the nail started peeling and developed tiny red spots on it.

Distal Toe Problem

The flesh is extremely tender to the touch. The skin peels and cracks, and red spots come and go. The peeling is spreading to the sides and underside of the toe. Any suggestions?

G Stephen Gill, DPM, Denver, CO

Query: Best Networks to Join

With the future on Medicare pay cuts still uncertain, I have been concerned about the way my practice will survive. I am thinking of taking the plunge into the in-network private insurance pool. I recently read (USA Today 6/21/10) that Medicare pays on average 78% of what private insurance pays, yet I find that difficult to believe. Each time I get an offer to join a network, I look at the fee schedule and see most often that the reimbursements are below Medicare rates. What are the best networks to join? 

Steve Bennett, DPM, NYC, NY

RE: Evidence-Based Medicine
From: Dwight L. Bates, DPM

This diagram illustrates that EBM allows considerable freedom by the doctor and/or patient as to treatment.

Evidence-Based Medicine Triad

It seems to me that EBM is a guide or road-map that helps you get to where you want to go. A guide does not dictate your desired destination.   

Dwight L. Bates, DPM, Dallas, TX, dlbates04@yahoo.com

RE: Integrative Podiatric Medicine (Arnold B. Wolf, DPM)
From: Elliot Udell, DPM

Dr. Wolf said it well when he pointed out that many more people survive illnesses because of modern medicine as opposed to those who choose to take unproven remedies. One point that needs to be emphasized is that "alternative healthcare" is not a monolithic plan of treatment. Alternative remedies run the gamut from treatments that might work in certain circumstances, such as tea tree oil for certain minor mycotic infections, to the extreme opposite of giving herbs to a patient with an early stage of melanoma or some other form of cancer rather than doing a biopsy and/or excising the lesion in total. In Great Britain, the medical community was up in arms when  homeopaths started promoting their products as prophylaxis to those traveling to malaria-invested parts of a world. They feared an epidemic of malaria in London.
 
We can discuss and argue this topic till the cows come home. There are two authoritative websites that we should all click on. One is called: quackwatch.com and the other is homeowatch.com. There we will find the history and dangers of the more common "alternative treatments" as well as dangerous new ones that come up day-to-day, solely limited by the imaginations of their inventors. 
 
Eliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Integrative Podiatric Medicine (Arnold B. Wolf, DPM)
From: Dennis Shavelson, DPM

In reference to drugs killing people, I am referring to short-term, poorly numbered RTC’s, funded by the companies making the drugs, researched by scientists being paid by the companies that later on must be overruled as invalid. An RTC, well-performed, starts at $100,000+ to fund. That stacks the players involved in favor of profit-driven corporations with biased interests. The companies then pay the scientists to perform the research. They then purchase podium time, sponsoring our conferences in addition to dinners at The Ritz, which reinforce their agenda.

When was the last time you saw an invited speaker who was paid by the hosting organization to lecture on an unrelated, but important topic from its sponsors? Please be realistic, Dr. Wolf. It is an unfortunate part of our great capitalistic system that profit drives all economic decisions because when it comes to areas like health, education of our children, and public safety issues, bias and greed come into play, leaving us with some of the major problems we face in America today.

I hold nothing personal against Dr. Wolf, but I suspect that he is denigrating a school of medicine that he has never done unbiased research on, and has never conceived of incorporating into his evidence-based practice. His faith-based argument on the orthodox point of view reflects similar faith-based comments being presented by the other side in this debate, and he simply wishes to preserve his incumbent ideology. I would like to sum up the righteous attitude of Dr. Wolf and other close-minded, self-proclaimed EBM watchdogs with a quote of Dr. Bret Ribotsky, who stated,“There has never been a double-blind study performed on parachutes.”

Dennis Shavelson, DPM, NYC, drsha@lifestylepodiatry.com

RE: Integrative Podiatric Medicine (Arnold Wolf, DPM)
From: Bob Kornfeld, DPM

I find it incredible that Dr. Wolf describes prescription drug-related deaths in this country as “interesting”. I think it is a lot of things, but not "interesting". While I totally agree that every day lives are “saved” by medications, I assert that our current medical paradigm has enabled the gross level of morbidity that requires “prescription heroics.”

Dr. Wolf admits that the statistics on drug-related deaths do not address co-morbidities that may exist in these situations. That is directly related to the fact that RCT’s for drugs absolutely do not consider...

Editor's Note: Dr. Kornfeld's extended-length letter can be read here.

RE: In-House vs. Outside Billing (Marc Baer, DPM)
From: David N. Helfman, DPM

As founder and CEO of Village Podiatry Centers, PC, I have had lots of experience with many companies and have tried outsourced billing companies in the past. The area that has worked well for us is using outside billing agencies for specialized areas of our company, i.e., surgery center, pathology lab, etc. We have chosen to do this to allow our focus in-house to be purely on podiatry claim management. We have tried early on to outsource our billing and collections but were never happy for a number of reasons. Podiatry is a very niche-focused area with lots of rules and modifier codes, and most companies say they can do a great job; but in reality, no one pays more attention to your money than you do. 

In addition, many of these companies have many clients and their focus is not going to be you 100% of the time; again, this has been my experience. Many billing companies promise the world and say they can save you lots of monies and price their services based on fees, but be careful, and don’t make your decision on price alone. You get what you pay for and cash flow is THE MOST IMPORTANT area of your company. Also, I know there are some podiatry-only billing companies, and that would make more sense after you have checked references to ensure their clients are happy with their productivity.

One piece of advice is that most companies which give out referrals for reference-checking pick their happiest clients. I would make sure that you get their entire client list and call at least 10 or more clients. Remember, this is one of the biggest decisions you will make for your practice that could have the biggest positive or negative impact.

David N. Helfman, DPM, Atlanta, GA , dhelfman@vpcenters.com

RE: Dragon Questions (Carl Solomon, DPM)
From: Simon Young, DPM

I thank Dr. Solomon for his suggestion. Unfortunately, the scenario that he presents is not the case. It seems there is a bug with MS word -"floating cursor" which Dragon has not addressed which seems to be the culprit.

Simon Young, DPM, NYC, simonyoung@juno.com

RE: Podiatric Curriculums (Leonard A. Levy, DPM, MPH) 
From: Ivar E. Roth DPM,MPH

Wow! Leonard Levy is right on. I never really gave this area much thought, but after reading his comments it made me think he is right. It is time to catch up and lead in this area.

Ivar E. Roth DPM, MPH, Newport Beach, CA, ifabs@earthlink.net

1-YEAR PODIATRIC SPORTS MEDICINE FELLOWSHIP - MONROVIA, CALIFORNIA

Applicants must have completed a podiatric residency program and must have or be eligible for a California license. Annual stipend: $48,000 and $60,000. If interested, please e-mail your resume with cover letter to the Program's management company at victoriamanagers@gmail.com

TN PRACTICE FOR SALE (SOUTH OF NASHVILLE)

Active, established practice with new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network with an excellent scope of practice. Turn-key operation with seamless transition. Grossed over $350K last year. Call 931-446-5724 or e-mail mchad500@gmail.com ASSOCIATE POSITION – COLORADO

Excellent opportunity to grow and expand a practice in the northern front range, Great compensation package with buy in potential. Desire individuals with motivation to succeed and grow professionally, Please fax CV and letter of interest to; 970-351-0940.

ASSOCIATE POSITION – LOS ANGELES AREA

Busy podiatry practice in South Bay, Los Angeles area looking for associate podiatric physician. Part-time initially. Good opportunity for young or established physician looking for additional work, income. Well established practice, large patient base, competent staff. Please send CV, respond to berstein.david@gmail.com

MANHATTAN MEDICAL SPACE AVAILABLE

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com Phone; 480-951-2480.

ASSOCIATE POSITION - SOUTHEAST GEORGIA

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

LIMB PRESERVATION RESEARCH AND SURGICAL FELLOWSHIP

Boston University Medical Center offers a unique fellowship position. Be part of this unique opportunity at a major internationally-known teaching medical center. During this time, he/she will become a knowledge expert who will contribute significantly to research, surgical procedures, teaching, and innovations in limb preservation and tissue repair. Requirements: Completion of a two or three year surgical residency; Annual Salary: Year 1 $61,000, Year 2 $66,000 plus excellent benefits. Submit a CV and letter of interest to: Erin Springhetti @ erin.springhetti@bmc.org and Dr Vickie Driver @ vickie.driver@bmc.org

ASSOCIATE POSITION – LONG ISLAND 
 
Busy Bellmore, NY office. Motivated, board certified, hard-working, experienced in all phases of podiatry. P/T hours available. excellent salary, call 516 242-7540 or Fax Resume 516 826-9036 or email jobke@aol.com

ASSOCIATE POSITIONS – TEXAS

Full-time podiatrist(s) needed in Austin or San Antonio. Current Texas license required. Unique mobile podiatry practice. Better pay, fine working conditions with excellent support staff. Check out our website www.footmobile.com. Reply to footcenter1@sbcglobal.net

PRACTICE FOR SALE - MINNESOTA

Practice Grossing over $500K yearly. Good mix of surgery, orthotics, DME, diabetic care, general podiatry. Commute < 5 miles to work. Friendly Midwest lakes area with arts, good schools, affordable living, restaurants, shopping. Option to purchase building. Will consider associate to buy-in/ buy-out. Midwestpractice@gmail.com

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

ASSOCIATE POSITION - FREDERICK, MARYLAND 
 
Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-time 3-DPM group in South Bay of LA County. Minutes from best living in LA County. Practice is an excellent mix of surgery, general podiatry, diabetic care, and DME. Beautiful office with EMR, Digital X-ray and Orthoses, etc. Please e-mail cover letter, and resume to footcareone@verizon.net

PODIATRISTS NEEDED NATIONWIDE

Seeking a part-time or full-time podiatrists to provide podiatry house call and diabetic shoe fitting services to patients nationwide. We are a podiatry management company and have contracts with clients that have 1,000’s of established patients and all we need are hard-working good doctors to service them. We offer an excellent compensation package with benefits and the opportunity to build a fairly large practice very quickly. coasttocoastpodiatry@yahoo.com

EQUIPMENT WANTED – CR SCANNER

Reina 812 Manual CR Scanner in good condition. Contact: pmh@wffeet.com

PM News Classified Ads Reach over 12,000 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 12,000 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

PRACTICE FOR SALE – MAINE

25 year full scope in medical building, podiatrist friendly hospitals, appreciative and cooperative patients, excellent expansion potential, physician referrals. Wonderful place to raise a family. Retiring seller will stay for transition. mainefootdoc@yahoo.com

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